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Asthma / Allergy

Our asthma/allergy section contains a wide range of medications that can be used to treat symptoms of asthma and other chronic airways diseases like chronic obstructive pulmonary disease (COPD), bronchitis and emphysema; also symptoms of allergy like hay fever (allergic rhinitis) and urticaria (hives).

The different classes of asthma/allergy medication are listed on the left of the page and when you click on one of these, the principal brand name products display in the left column and generic alternatives to the right.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. fluticasone or the product name, e.g. Flixotide.

Our asthma/allergy section contains a wide range of medications that can be used to treat symptoms of asthma and other chronic airways diseases like chronic obstructive pulmonary disease (COPD), bronchitis and emphysema; also symptoms of allergy like hay fever (allergic rhinitis) and urticaria (hives).

The different classes of asthma/allergy medication are listed on the left of the page and when you click on one of these, the principal brand name products display in the left column and generic alternatives to the right.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. fluticasone or the product name, e.g. Flixotide.

Our antihistamines class of asthma/allergy medications are used to relieve symptoms of allergy that affect the nasal passages, skin and eyes, caused by seasonal allergies like hay fever (allergic rhinitis) as well as perennial allergies caused by animal fur, mould and house dust mites. Also eye drops to treat allergic reactions affecting the eyes.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. Fexofenadine or the product name e.g. Allegra

Our antihistamines class of asthma/allergy medications are used to relieve symptoms of allergy that affect the nasal passages, skin and eyes, caused by seasonal allergies like hay fever (allergic rhinitis) as well as perennial allergies caused by animal fur, mould and house dust mites. Also eye drops to treat allergic reactions affecting the eyes.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. Fexofenadine or the product name e.g. Allegra

Oral antihistamines

Symptoms of allergy are caused primarily by the action of histamine, a chemical released from mast cells, which are specialised cells found in most tissues and are involved in inflammatory and allergic reactions. Antihistamines bind to histamine receptors in small blood vessels, as well as in the nasal passages, eyes, skin or any other tissue involved in an allergic reaction, blocking the action of histamine. This relieves symptoms like nasal congestion runny itchy nose, sneezing, tearing, itchy, red, and puffy eyes. Also red itchy lumps on the skin (hives) and other symptoms of allergy.

Most antihistamines are non-sedating because they only act locally; they include fexofenadine, loratadine and cetirizine. Promethazine is a sedating antihistamine because as well as blocking histamine receptors in the tissues, it also passes into the central nervous system and binds to other histamine receptors in the brain, which are involved in stress and anxiety reactions, blocking these responses.

Antihistamine eye drops

Olopatadine is an antihistamine that is used in eye drops to treat symptoms of allergic conjunctivitis, which is irritation and inflammation of the eye due to contact with an allergen like pollen. Olopatadine blocks histamine action by binding to histamine receptors on the conjunctiva (membrane covering the white part of the eye or sclera) of the eye as well as blocking histamine release from mast cells in the eye.

Antihistamine nasal spray

Azelastaline is a fast-acting, long-lasting antihistamine used as a nasal spray to relieve symptoms of allergy. It works by binding to histamine receptors in the cells of the nasal passages and blocks the action of histamine; it also acts directly on mast cells to reduce the amount of histamine released.

Oral antihistamines

Symptoms of allergy are caused primarily by the action of histamine, a chemical released from mast cells, which are specialised cells found in most tissues and are involved in inflammatory and allergic reactions. Antihistamines bind to histamine receptors in small blood vessels, as well as in the nasal passages, eyes, skin or any other tissue involved in an allergic reaction, blocking the action of histamine. This relieves symptoms like nasal congestion runny itchy nose, sneezing, tearing, itchy, red, and puffy eyes. Also red itchy lumps on the skin (hives) and other symptoms of allergy.

Most antihistamines are non-sedating because they only act locally; they include fexofenadine, loratadine and cetirizine. Promethazine is a sedating antihistamine because as well as blocking histamine receptors in the tissues, it also passes into the central nervous system and binds to other histamine receptors in the brain, which are involved in stress and anxiety reactions, blocking these responses.

Antihistamine eye drops

Olopatadine is an antihistamine that is used in eye drops to treat symptoms of allergic conjunctivitis, which is irritation and inflammation of the eye due to contact with an allergen like pollen. Olopatadine blocks histamine action by binding to histamine receptors on the conjunctiva (membrane covering the white part of the eye or sclera) of the eye as well as blocking histamine release from mast cells in the eye.

Antihistamine nasal spray

Azelastaline is a fast-acting, long-lasting antihistamine used as a nasal spray to relieve symptoms of allergy. It works by binding to histamine receptors in the cells of the nasal passages and blocks the action of histamine; it also acts directly on mast cells to reduce the amount of histamine released.

Our anti-inflammatory class of asthma/allergy medications are used as inhalers to treat chronic inflammation of the airways that is the underlying cause of respiratory diseases like asthma. Oral anti-inflammatory drugs are also used to treat severe asthma or allergy.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. fluticasone or the product name e.g. Flixotide

Our anti-inflammatory class of asthma/allergy medications are used as inhalers to treat chronic inflammation of the airways that is the underlying cause of respiratory diseases like asthma. Oral anti-inflammatory drugs are also used to treat severe asthma or allergy.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. fluticasone or the product name e.g. Flixotide

About anti-inflammatory drugs

Most anti-inflammatory medications are synthetic corticosteroids and are available as inhalers. They are used for regular preventer medication in the long-term management of asthma to prevent asthma worsening by reducing damage to the airways that can happen if chronic inflammation is not treated. Oral corticosteroids are available to treat more severe symptoms of both asthma and allergy but these are not usually a long-term medication. Also available are inhaled non-steroidal anti-inflammatory drugs (NSAID), which can be used for management of asthma.

How do corticosteroids work?

Corticosteroids are produced naturally by the body and are involved in regulation of many functions including inflammatory and allergic reactions. Synthetic corticosteroids mimic natural corticosteroids and work by inhibiting the production of inflammatory chemicals, particularly prostaglandins and leukotrienes. They act at several different stages in the production of these chemicals by inflammatory cells at sites of inflammation, like the bronchioles. Corticosteroids do not have an immediate effect on symptoms of asthma and cannot relieve an asthma attack, but if taken regularly they reduce inflammation and swelling of the airways, as well as excess mucus production. This helps prevent sensitive airways overreacting to asthma triggers by constricting and narrowing, which is what causes symptoms like wheezing, cough, tightness across the chest and shortness of breath.

Inhaled corticosteroids

Corticosteroids used for treating asthma and other chronic breathing disorders are taken by inhaling through an inhaler device so that they act directly at site of inflammation in the airways and have very little systemic effect. Inhaled corticosteroids include fluticasone, beclomethasone and budesonide.

Oral corticosteroids

If asthma or allergy is severe and cannot be controlled by other medications, oral corticosteroids can be used to treat inflammation, which reduces the swelling and excess mucus production that causes severe breathing problems in uncontrolled asthma; also extreme symptoms of an allergic reaction such as in allergic inflammatory skin conditions. They should be taken only until symptoms are reduced, as long-term use of oral corticosteroids like prednisone and hydrocortisone can have severe side effects.

Inhaled non-steroidal anti-inflammatory (NSAID)

Another inhaled anti-inflammatory medication used for long-term treatment of mild to moderate chronic asthma is the non-steroidal anti-inflammatory (NSAID) nedocromil. It works by inhibiting the release of a range of inflammatory chemicals like prostaglandins from cells lining the airways as well as other cells like macrophages; also histamine release from mast cells that are known to be involved in inflammation of the airways. This medication is not intended for rapid symptom relief but will improve lung function and reduce the frequency and severity of symptoms over time. Nedocromil can be used in addition to other asthma medications.

About anti-inflammatory drugs

Most anti-inflammatory medications are synthetic corticosteroids and are available as inhalers. They are used for regular preventer medication in the long-term management of asthma to prevent asthma worsening by reducing damage to the airways that can happen if chronic inflammation is not treated. Oral corticosteroids are available to treat more severe symptoms of both asthma and allergy but these are not usually a long-term medication. Also available are inhaled non-steroidal anti-inflammatory drugs (NSAID), which can be used for management of asthma.

How do corticosteroids work?

Corticosteroids are produced naturally by the body and are involved in regulation of many functions including inflammatory and allergic reactions. Synthetic corticosteroids mimic natural corticosteroids and work by inhibiting the production of inflammatory chemicals, particularly prostaglandins and leukotrienes. They act at several different stages in the production of these chemicals by inflammatory cells at sites of inflammation, like the bronchioles. Corticosteroids do not have an immediate effect on symptoms of asthma and cannot relieve an asthma attack, but if taken regularly they reduce inflammation and swelling of the airways, as well as excess mucus production. This helps prevent sensitive airways overreacting to asthma triggers by constricting and narrowing, which is what causes symptoms like wheezing, cough, tightness across the chest and shortness of breath.

Inhaled corticosteroids

Corticosteroids used for treating asthma and other chronic breathing disorders are taken by inhaling through an inhaler device so that they act directly at site of inflammation in the airways and have very little systemic effect. Inhaled corticosteroids include fluticasone, beclomethasone and budesonide.

Oral corticosteroids

If asthma or allergy is severe and cannot be controlled by other medications, oral corticosteroids can be used to treat inflammation, which reduces the swelling and excess mucus production that causes severe breathing problems in uncontrolled asthma; also extreme symptoms of an allergic reaction such as in allergic inflammatory skin conditions. They should be taken only until symptoms are reduced, as long-term use of oral corticosteroids like prednisone and hydrocortisone can have severe side effects.

Inhaled non-steroidal anti-inflammatory (NSAID)

Another inhaled anti-inflammatory medication used for long-term treatment of mild to moderate chronic asthma is the non-steroidal anti-inflammatory (NSAID) nedocromil. It works by inhibiting the release of a range of inflammatory chemicals like prostaglandins from cells lining the airways as well as other cells like macrophages; also histamine release from mast cells that are known to be involved in inflammation of the airways. This medication is not intended for rapid symptom relief but will improve lung function and reduce the frequency and severity of symptoms over time. Nedocromil can be used in addition to other asthma medications.

Our bronchodilator class of asthma/allergy medications are used as inhalers to relieve symptoms of asthma and other chronic respiratory diseases like chronic obstructive pulmonary disease (COPD), including bronchitis and emphysema; also orally for severe symptoms.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. salmeterol or the product name e.g. Serevent

Our bronchodilator class of asthma/allergy medications are used as inhalers to relieve symptoms of asthma and other chronic respiratory diseases like chronic obstructive pulmonary disease (COPD), including bronchitis and emphysema; also orally for severe symptoms.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. salmeterol or the product name e.g. Serevent

What is bronchospasm?

Bronchospasm is the constriction and narrowing of sensitive and/or inflamed bronchioles in response to an asthma trigger. Bronchospasm is triggered by an inhaled allergen, irritant, cold air, exercise, emotions or can be triggered by some medications like aspirin. Narrowing or the airways is the cause of symptoms like tightness of the chest, shortness of breath, wheezing and cough.

About bronchodilators

All bronchodilators act directly on the bronchioles causing them to dilate or widen, which makes breathing easier. However, there are several different mechanisms by which these medications are effective and some are fast-acting, while others are slower to act but are more long-lasting. Most bronchodilators are taken by inhalation although an oral form is available for taking as tablets.

How do bronchodilators work?

When the bands of smooth muscle surrounding the bronchioles contract and tighten, hey cause the bronchioles to narrow or constrict, which causes difficulty breathing. Bronchodilators act directly on the smooth muscle causing them to relax and this opens up the airways. Two types of bronchodilator are used:

Beta 2-agonists bind to and stimulate specific beta 2 adrenergic receptors in the smooth muscle and this causes the airways to relax and widen (bronchodilation). Some are fast-acting and can be used for rescue medication, others are slower to act but are longer lasting and are used to relieve or control symptoms.

Anticholinergics block the cholinergic receptors in the smooth muscles of the bronchioles to inhibit muscle contraction and this allows them to widen. These bronchodilators are used for COPD and chronic severe asthma.

Inhaled beta 2-agonists

Salbutamol is a fast-acting bronchodilator that is used as a rescue medication to relieve symptoms of acute asthma or asthma attack. It is usually effective within 5 minutes, lasts for 4-6 hours, and should only be used when needed and not as a regular medication. An asthma preventer should be used for long-term management of asthma. Salmeterol and formoterol are long-acting bronchodilators that can be used with or without a preventer asthma medication but cannot be used as a rescue medication because of their slow onset of action (10 to 20 minutes). These long-acting bronchodilators are particularly helpful for managing exercise-induced asthma and nocturnal symptoms in asthma, such as night-time cough.

Nebulised beta 2-agonists

Salbutamol and levosalbutamol can be nebulised into a fine aerosol using a nebuliser that creates a fine mist. The bronchodilator medication is then inhaled through a face mask or mouthpiece which is easier for treating severe asthma attack, particularly in children.

Inhaled anticholinergics

Ipratropium and tiotropium are anticholinergic bronchodilators that are used as long-term treatments for chronic obstructive pulmonary disease (COPD) and other obstructive airways disease, like chronic bronchitis, and emphysema. They are delivered into the airways as a dry powder using a special device.

Oral bronchodilators

Salbutamol is available as slow release tablets that are effective within 15 minutes and lasts for up to 8 hours. They are particularly helpful for nocturnal asthma and for severe or unstable asthma, but only in addition to a preventer medication and they are not suitable for asthma attack.

What is bronchospasm?

Bronchospasm is the constriction and narrowing of sensitive and/or inflamed bronchioles in response to an asthma trigger. Bronchospasm is triggered by an inhaled allergen, irritant, cold air, exercise, emotions or can be triggered by some medications like aspirin. Narrowing or the airways is the cause of symptoms like tightness of the chest, shortness of breath, wheezing and cough.

About bronchodilators

All bronchodilators act directly on the bronchioles causing them to dilate or widen, which makes breathing easier. However, there are several different mechanisms by which these medications are effective and some are fast-acting, while others are slower to act but are more long-lasting. Most bronchodilators are taken by inhalation although an oral form is available for taking as tablets.

How do bronchodilators work?

When the bands of smooth muscle surrounding the bronchioles contract and tighten, hey cause the bronchioles to narrow or constrict, which causes difficulty breathing. Bronchodilators act directly on the smooth muscle causing them to relax and this opens up the airways. Two types of bronchodilator are used:

Beta 2-agonists bind to and stimulate specific beta 2 adrenergic receptors in the smooth muscle and this causes the airways to relax and widen (bronchodilation). Some are fast-acting and can be used for rescue medication, others are slower to act but are longer lasting and are used to relieve or control symptoms.

Anticholinergics block the cholinergic receptors in the smooth muscles of the bronchioles to inhibit muscle contraction and this allows them to widen. These bronchodilators are used for COPD and chronic severe asthma.

Inhaled beta 2-agonists

Salbutamol is a fast-acting bronchodilator that is used as a rescue medication to relieve symptoms of acute asthma or asthma attack. It is usually effective within 5 minutes, lasts for 4-6 hours, and should only be used when needed and not as a regular medication. An asthma preventer should be used for long-term management of asthma. Salmeterol and formoterol are long-acting bronchodilators that can be used with or without a preventer asthma medication but cannot be used as a rescue medication because of their slow onset of action (10 to 20 minutes). These long-acting bronchodilators are particularly helpful for managing exercise-induced asthma and nocturnal symptoms in asthma, such as night-time cough.

Nebulised beta 2-agonists

Salbutamol and levosalbutamol can be nebulised into a fine aerosol using a nebuliser that creates a fine mist. The bronchodilator medication is then inhaled through a face mask or mouthpiece which is easier for treating severe asthma attack, particularly in children.

Inhaled anticholinergics

Ipratropium and tiotropium are anticholinergic bronchodilators that are used as long-term treatments for chronic obstructive pulmonary disease (COPD) and other obstructive airways disease, like chronic bronchitis, and emphysema. They are delivered into the airways as a dry powder using a special device.

Oral bronchodilators

Salbutamol is available as slow release tablets that are effective within 15 minutes and lasts for up to 8 hours. They are particularly helpful for nocturnal asthma and for severe or unstable asthma, but only in addition to a preventer medication and they are not suitable for asthma attack.

Our combination inhalers combine two medications, usually an anti-inflammatory corticosteroid and a bronchodilator or two different types of bronchodilator that work by different mechanisms to prevent and control symptoms of asthma and other chronic respiratory diseases.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. budesonide or the product name e.g. Symbicort.

Our combination inhalers combine two medications, usually an anti-inflammatory corticosteroid and a bronchodilator or two different types of bronchodilator that work by different mechanisms to prevent and control symptoms of asthma and other chronic respiratory diseases.

Use the search feature to quickly find the product you are looking for by entering either the active ingredient, e.g. budesonide or the product name e.g. Symbicort.

Corticosteroid/bronchodilator combination

The combination of a corticosteroid like fluticasone or budesonide with a long-acting bronchodilator like salmeterol and formotero in one inhaler can be used for long-term asthma management, as it contains both an anti-inflammatory, to reduce inflammation and improve lung function, also a bronchodilator to relieve symptoms of bronchospasm. For asthmatics whose symptoms are already well controlled using a preventer and controller/reliever medication individually, the combination inhaler is more convenient to use and often provides better control than a preventer inhaler alone. However this type of combination medication is not suitable for severe asthma or asthma attack. A corticosteroid/ bronchodilator combination can also be used for maintenance therapy of moderate to severe chronic obstructive pulmonary disease (COPD).

Bronchodilator combinations

The combination of salbutamol or levosalbutamol, both short-acting beta agonists, with ipratropium, an anticholinergic, has a synergistic action (one drug enhances the action of the other), so that the combination is more effective as a bronchodilator than each individual drug alone. This combination can be used to widen the airways and relieve symptoms of asthma, COPD, bronchitis and emphysema and may also be used in addition to another reliever bronchodilator, if needed to control symptoms.

Corticosteroid/bronchodilator combination

The combination of a corticosteroid like fluticasone or budesonide with a long-acting bronchodilator like salmeterol and formotero in one inhaler can be used for long-term asthma management, as it contains both an anti-inflammatory, to reduce inflammation and improve lung function, also a bronchodilator to relieve symptoms of bronchospasm. For asthmatics whose symptoms are already well controlled using a preventer and controller/reliever medication individually, the combination inhaler is more convenient to use and often provides better control than a preventer inhaler alone. However this type of combination medication is not suitable for severe asthma or asthma attack. A corticosteroid/ bronchodilator combination can also be used for maintenance therapy of moderate to severe chronic obstructive pulmonary disease (COPD).

Bronchodilator combinations

The combination of salbutamol or levosalbutamol, both short-acting beta agonists, with ipratropium, an anticholinergic, has a synergistic action (one drug enhances the action of the other), so that the combination is more effective as a bronchodilator than each individual drug alone. This combination can be used to widen the airways and relieve symptoms of asthma, COPD, bronchitis and emphysema and may also be used in addition to another reliever bronchodilator, if needed to control symptoms.

About inhaler devices

Inhaler devices are designed to help deliver inhaled medication into the airways in the most efficient manner and with minimal loss of medication. Inhaled medication is used for treating, preventing and controlling symptoms of asthma and other chronic respiratory diseases like chronic obstructive pulmonary disease (COPD).

The type of device used depends on the type of medication and delivery mechanism being used and includes:

Spacer device for use with a metered dose inhaler

Dry powder inhalation device for use with capsules

Spacer devices for aerosol inhalers

Aerosols, containing respiratory medication and a propellant are generated using a pressurised metered dose inhaler (MDI). These particles are often generated at a faster rate than can be inhaled by the user, as this takes considerable coordination between actuation of the inhaler and inhalation of the aerosol. Poor coordination results in deposition of these particles at the back of the throat, which can cause local side effects, such as yeast infection due to inhaled steroids; also the amount of medication reaching the airways can be reduced if deposited in the throat.

The MDI is attached to one end of the spacer device, which acts as an interface between the patient and the medication, minimising need for coordination with the inhaler. The aerosol medication is delivered into a spacer, which is essentially a tube with a mouthpiece at the other end. A spacer device can also include a valve and this type of spacer is also called a holding chamber, since the aerosol is held in the chamber for longer to allow for controlled deep inhalations from the aerosol cloud within the spacer, which reduces the risk of exhaling into the chamber

The spacer also allows the aerosol to break into smaller droplets before being inhaled, which increases the efficiency of drug delivery into the lungs.

A spacer device can be coated to prevent loss of medication by sticking due to static.

Dry powder inhaler devices

A dry powder inhaler (DPI) is a device for delivering medication directly into the lungs in the form of a small particulate dry powder, without the use of a propellant. The delivery mechanism depends on the force of inhalation and is generally designed to be used with minimal inhalation force.

A device for use with a DPI is available to dispense the contents of a single dose contained within an individual capsule. A capsule must be loaded into the device, which then pierces the capsule releasing the powder containing the medication for inhalation. This form of delivery is activated by inhalation and therefore, less coordination is needed. When the contents of a capsule have been inhaled, the capsule must be removed from the device before another capsule can be loaded.
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About inhaler devices

Inhaler devices are designed to help deliver inhaled medication into the airways in the most efficient manner and with minimal loss of medication. Inhaled medication is used for treating, preventing and controlling symptoms of asthma and other chronic respiratory diseases like chronic obstructive pulmonary disease (COPD).

The type of device used depends on the type of medication and delivery mechanism being used and includes:

Spacer device for use with a metered dose inhaler

Dry powder inhalation device for use with capsules

Spacer devices for aerosol inhalers

Aerosols, containing respiratory medication and a propellant are generated using a pressurised metered dose inhaler (MDI). These particles are often generated at a faster rate than can be inhaled by the user, as this takes considerable coordination between actuation of the inhaler and inhalation of the aerosol. Poor coordination results in deposition of these particles at the back of the throat, which can cause local side effects, such as yeast infection due to inhaled steroids; also the amount of medication reaching the airways can be reduced if deposited in the throat.

The MDI is attached to one end of the spacer device, which acts as an interface between the patient and the medication, minimising need for coordination with the inhaler. The aerosol medication is delivered into a spacer, which is essentially a tube with a mouthpiece at the other end. A spacer device can also include a valve and this type of spacer is also called a holding chamber, since the aerosol is held in the chamber for longer to allow for controlled deep inhalations from the aerosol cloud within the spacer, which reduces the risk of exhaling into the chamber

The spacer also allows the aerosol to break into smaller droplets before being inhaled, which increases the efficiency of drug delivery into the lungs.

A spacer device can be coated to prevent loss of medication by sticking due to static.

Dry powder inhaler devices

A dry powder inhaler (DPI) is a device for delivering medication directly into the lungs in the form of a small particulate dry powder, without the use of a propellant. The delivery mechanism depends on the force of inhalation and is generally designed to be used with minimal inhalation force.

A device for use with a DPI is available to dispense the contents of a single dose contained within an individual capsule. A capsule must be loaded into the device, which then pierces the capsule releasing the powder containing the medication for inhalation. This form of delivery is activated by inhalation and therefore, less coordination is needed. When the contents of a capsule have been inhaled, the capsule must be removed from the device before another capsule can be loaded.
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What is anaphylaxis?

Anaphylaxis or anaphylactic shock is an acute, rapid and severe allergic reaction caused by a sudden release of histamine from white blood cells including mast cells and basophils. Histamine is involved in allergic reactions and binds to receptors in small blood vessels causing them to dilate and widen, which allows leakage of fluid into the surrounding tissues, causing swelling. Anaphylaxis is induced by an allergen, which is a substance that the immune system reacts to as a potential threat, most commonly foods like peanuts, shellfish and eggs; a bee or wasp sting, and latex; also some medicines like aspirin and penicillin. It can be life-threatening if not treated rapidly, with symptoms including drop in blood pressure, increased heart rate, difficulty breathing and wheezing due to bronchospasm (narrowing of the airways), swelling of the throat, tongue and face. Anaphylaxis does not usually occur on the first exposure. For example, the first bee sting sensitises the immune system resulting in a stronger allergic reaction with the next sting and increasing risk of anaphylaxis.

Emergency treatment for anaphylaxis

Adrenaline (or epinephrine) is a naturally occurring hormone produced by the adrenal gland and also by certain nerve cells and is released in response to stress. It causes constriction and narrowing of blood vessels, increased heart rate and widening of the air passages, all of which under normal conditions contribute to preparation for the “fight or flight” response.

Adrenaline is used for emergency treatment of acute anaphylaxis and works by binding to specific adrenergic receptors on blood vessels walls causing them to constrict and become less permeable; also on bronchial smooth muscle of the airways, causing them to relax and widen, which helps return breathing to normal; and on the heart, which helps return heart beat to normal, as well as increasing blood pressure. When injected as soon as possible after exposure to the allergen, adrenaline can relieve life-threatening symptoms.

What is anaphylaxis?

Anaphylaxis or anaphylactic shock is an acute, rapid and severe allergic reaction caused by a sudden release of histamine from white blood cells including mast cells and basophils. Histamine is involved in allergic reactions and binds to receptors in small blood vessels causing them to dilate and widen, which allows leakage of fluid into the surrounding tissues, causing swelling. Anaphylaxis is induced by an allergen, which is a substance that the immune system reacts to as a potential threat, most commonly foods like peanuts, shellfish and eggs; a bee or wasp sting, and latex; also some medicines like aspirin and penicillin. It can be life-threatening if not treated rapidly, with symptoms including drop in blood pressure, increased heart rate, difficulty breathing and wheezing due to bronchospasm (narrowing of the airways), swelling of the throat, tongue and face. Anaphylaxis does not usually occur on the first exposure. For example, the first bee sting sensitises the immune system resulting in a stronger allergic reaction with the next sting and increasing risk of anaphylaxis.

Emergency treatment for anaphylaxis

Adrenaline (or epinephrine) is a naturally occurring hormone produced by the adrenal gland and also by certain nerve cells and is released in response to stress. It causes constriction and narrowing of blood vessels, increased heart rate and widening of the air passages, all of which under normal conditions contribute to preparation for the “fight or flight” response.

Adrenaline is used for emergency treatment of acute anaphylaxis and works by binding to specific adrenergic receptors on blood vessels walls causing them to constrict and become less permeable; also on bronchial smooth muscle of the airways, causing them to relax and widen, which helps return breathing to normal; and on the heart, which helps return heart beat to normal, as well as increasing blood pressure. When injected as soon as possible after exposure to the allergen, adrenaline can relieve life-threatening symptoms.

How do LTRAs work?

Inflammation of the airways is characterised by the presence of inflammatory white blood cells like mast cells and eosinophils which are involved in immune and inflammatory responses and produce chemicals that control these responses. Leukotrienes are one such inflammatory mediator and overproduction of leukotrienes is directly involved in causing symptoms of asthma in the airways and allergy in nasal passages. Leukotrienes are synthesised in response to several triggers, including an allergic reaction, physical stimulus like cold, which can in turn both trigger asthma. A leukotriene receptor antagonist (LTRA) like montelukast binds to specific leukotriene receptors on cells of the bronchioles and also other cells like macrophages that migrate to the airways, and this blocks the action of leukotrienes. These LTRA medications are taken orally in tablet form to prevent leukotriene-mediated inflammation in asthma and allergic rhinitis and are slow-acting but long-lasting in their action.

LTRAs for asthma

When leukotrienes are released into the airways in response to an asthma trigger, they directly cause contraction of the smooth muscle of the bronchioles; also increased mucus production by secreting cells of the airways. These leukotriene-mediated effects cause bronchoconstriction or narrowing of the airways, inflammation, swelling and mucous secretion. LTRA medications are used to help manage chronic asthma and prevent exacerbations and asthma attack, but not to treat asthma attack. They are particularly useful for nocturnal and exercise-induced asthma because they are long-acting.

LTRAs for allergy

When leukotrienes are released into the nasal passages after exposure to an allergen like pollen or house dust mites they cause irritation and inflammation and this leads to symptoms of allergic rhinitis, including nasal congestion, runny itchy nose and sneezing. LTRA medications are used to treat seasonal allergy to pollen, also known as hay fever, and perennial allergy, such as to animal fur, mould and house dust mites, to relieve symptoms of allergic rhinitis.

How do LTRAs work?

Inflammation of the airways is characterised by the presence of inflammatory white blood cells like mast cells and eosinophils which are involved in immune and inflammatory responses and produce chemicals that control these responses. Leukotrienes are one such inflammatory mediator and overproduction of leukotrienes is directly involved in causing symptoms of asthma in the airways and allergy in nasal passages. Leukotrienes are synthesised in response to several triggers, including an allergic reaction, physical stimulus like cold, which can in turn both trigger asthma. A leukotriene receptor antagonist (LTRA) like montelukast binds to specific leukotriene receptors on cells of the bronchioles and also other cells like macrophages that migrate to the airways, and this blocks the action of leukotrienes. These LTRA medications are taken orally in tablet form to prevent leukotriene-mediated inflammation in asthma and allergic rhinitis and are slow-acting but long-lasting in their action.

LTRAs for asthma

When leukotrienes are released into the airways in response to an asthma trigger, they directly cause contraction of the smooth muscle of the bronchioles; also increased mucus production by secreting cells of the airways. These leukotriene-mediated effects cause bronchoconstriction or narrowing of the airways, inflammation, swelling and mucous secretion. LTRA medications are used to help manage chronic asthma and prevent exacerbations and asthma attack, but not to treat asthma attack. They are particularly useful for nocturnal and exercise-induced asthma because they are long-acting.

LTRAs for allergy

When leukotrienes are released into the nasal passages after exposure to an allergen like pollen or house dust mites they cause irritation and inflammation and this leads to symptoms of allergic rhinitis, including nasal congestion, runny itchy nose and sneezing. LTRA medications are used to treat seasonal allergy to pollen, also known as hay fever, and perennial allergy, such as to animal fur, mould and house dust mites, to relieve symptoms of allergic rhinitis.

Allergic rhinitis

Hay fever is a more common term for one form of allergic rhinitis, and is a seasonal allergy to pollen. The same symptoms can be caused by perennial allergy to year-round allergens such as animal dander, mould and house dust mites. Symptoms include runny itchy nose, sneezing, tearing, itchy, red, puffy eyes and nasal congestion, due to local inflammation caused by the allergic reaction. All these symptoms can affect daytime alertness and cause problems sleeping.

Antihistamine nasal sprays

The antihistamine azelastine works by binding to histamine (H1) receptors in the cells of the nasal passages and blocks the action of histamine, a chemical released from mast cells in response to allergens like pollen. Azelastine also acts directly on the mast cells to reduce the amount of histamine released. A nasal spry provides fast-acting medication at the site where it is needed; it takes effect rapidly within 15 minutes and lasts for up to 12 hours.

Corticosteroid nasal sprays

Corticosteroids used in nasal sprays include triamcinolone, mometasone, beclomethasone and fluticasone. These corticosteroids are used as topical anti-inflammatories and work by blocking the production of inflammatory chemicals, like prostaglandins and leukotrienes in the nasal passages. This action reduces symptoms of inflammation, like mucus production, swelling and irritation, which helps relieve symptoms of allergy including runny itchy nose, nasal congestion and sneezing. Mometasone is also used to treat nasal polyps, which are growths in the nose that often develop at the same time as allergic rhinitis and are thought to be caused by the allergy.
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Allergic rhinitis

Hay fever is a more common term for one form of allergic rhinitis, and is a seasonal allergy to pollen. The same symptoms can be caused by perennial allergy to year-round allergens such as animal dander, mould and house dust mites. Symptoms include runny itchy nose, sneezing, tearing, itchy, red, puffy eyes and nasal congestion, due to local inflammation caused by the allergic reaction. All these symptoms can affect daytime alertness and cause problems sleeping.

Antihistamine nasal sprays

The antihistamine azelastine works by binding to histamine (H1) receptors in the cells of the nasal passages and blocks the action of histamine, a chemical released from mast cells in response to allergens like pollen. Azelastine also acts directly on the mast cells to reduce the amount of histamine released. A nasal spry provides fast-acting medication at the site where it is needed; it takes effect rapidly within 15 minutes and lasts for up to 12 hours.

Corticosteroid nasal sprays

Corticosteroids used in nasal sprays include triamcinolone, mometasone, beclomethasone and fluticasone. These corticosteroids are used as topical anti-inflammatories and work by blocking the production of inflammatory chemicals, like prostaglandins and leukotrienes in the nasal passages. This action reduces symptoms of inflammation, like mucus production, swelling and irritation, which helps relieve symptoms of allergy including runny itchy nose, nasal congestion and sneezing. Mometasone is also used to treat nasal polyps, which are growths in the nose that often develop at the same time as allergic rhinitis and are thought to be caused by the allergy.
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What is asthma?

Asthma is a chronic disease that affects the smallest airways of the lungs called bronchioles. Symptoms include wheezing, cough, tightness of the chest and shortness of breath and are caused by contraction of the smooth muscle surrounding the bronchioles, which in turn causes narrowing or constriction of the bronchioles, known as bronchospasm. The underlying cause of asthma is inflammation, which may be triggered by an allergic reaction or a reaction to an irritant; also asthma attack can be triggered by exercise, some medications like aspirin, stress and other emotions.

Chronic obstructive pulmonary disease (COPD) is another respiratory disorder where breathing is impaired, caused by chronic inflammation and damage to the bronchioles.

What is an allergy?

An allergy is the result of an allergic reaction when the immune system reacts to a substance that is not normally harmful. The type of allergic reaction depends on the cause and the allergen, which is the substance that induces an allergic reaction. For example, Asthma can be triggered by an allergy to inhaled pollen, mould, animal fur or house dust mites. These allergens can also trigger allergic rhinitis. Urticaria or hives is an allergic reaction of the skin, often caused by allergy to a medicine, a food, an insect sting or latex gloves.

An allergy can also affect other parts of the body, such as the gastrointestinal system causing stomach pain, diarrhea and vomiting. A severe allergic reaction called anaphylaxis can cause swelling of the throat and tongue, difficulty breathing, drop in blood pressure and can be life-threatening.

Types of asthma medication

Medication available for the treatment of asthma and other chronic breathing disorders fall into three categories:

bronchodilators treat and relieve symptoms of brochospasm and include beta 2-agonists and anticholinergics.

anti-inflammatory drugs treat the underlying inflammation by inhibiting the production of inflammatory chemicals like prostaglandins and include corticosteroids and non-steroidal anti-inflammatory drugs (NSAID).

Leukotriene receptor antagonists treat both symptoms of brochospasm and inflammation.

Inhaled asthma medication

Most asthma medications are taken using an inhaler so that the drug goes directly to its target, the airways of the lungs. Inhaled asthma medications may be delivered as an aerosol with a metered dose inhaler (puffer) using a propellant gas to create an aerosol, or by a nebuliser that creates a fine mist which can be inhaled using a mask or mouthpiece. The medication may also be inhaled as a dry powder using a special device for powder delivery.

Inhalers are used for brochodilators, or reliever medications that are generally for symptom relief or asthma attack; and for anti-inflammatory drugs, which are preventer medications for chronic inflammation of the airways. Combination inhalers are also available which contain two different drugs in the same inhalation device.

Types of inhaler

Inhaler devices used to deliver medication into the airways are:

Metered dose inhaler (MDI) that uses a propellant gas to create an aerosol. Most are now CFC-free as these less damaging to the environment.

Dry powder inhaler, such as the accuhaler, turbuhaler or rotahaler that does not need a propellant.

Oral asthma/allergy medication

Some steroid medication for severe asthma or allergy can be taken orally as tablets to gain control of symptoms. Leukotriene receptor antagonists are also taken orally as tablets.

Types of allergy medication

Allergy medications are known as antihistamines because they block the action of histamine, a chemical released during an allergic reaction that is responsible for triggering symptoms of allergy. Most antihistamines are taken orally as tablets and are non-sedating. Some antihistamines are sedating because they also act on the central nervous system. Antihistamines can also be taken as eye drops and using a nasal spray.

Nasal sprays for treating allergy

Allergy medications can also be taken as a nasal sprays. The types of medication available as a nasal spray include antihistamines to treat symptoms of allergy; also corticosteroids that treat symptoms of inflammation of the nasal passages caused by an allergic reaction.

What is asthma?

Asthma is a chronic disease that affects the smallest airways of the lungs called bronchioles. Symptoms include wheezing, cough, tightness of the chest and shortness of breath and are caused by contraction of the smooth muscle surrounding the bronchioles, which in turn causes narrowing or constriction of the bronchioles, known as bronchospasm. The underlying cause of asthma is inflammation, which may be triggered by an allergic reaction or a reaction to an irritant; also asthma attack can be triggered by exercise, some medications like aspirin, stress and other emotions.

Chronic obstructive pulmonary disease (COPD) is another respiratory disorder where breathing is impaired, caused by chronic inflammation and damage to the bronchioles.

What is an allergy?

An allergy is the result of an allergic reaction when the immune system reacts to a substance that is not normally harmful. The type of allergic reaction depends on the cause and the allergen, which is the substance that induces an allergic reaction. For example, Asthma can be triggered by an allergy to inhaled pollen, mould, animal fur or house dust mites. These allergens can also trigger allergic rhinitis. Urticaria or hives is an allergic reaction of the skin, often caused by allergy to a medicine, a food, an insect sting or latex gloves.

An allergy can also affect other parts of the body, such as the gastrointestinal system causing stomach pain, diarrhea and vomiting. A severe allergic reaction called anaphylaxis can cause swelling of the throat and tongue, difficulty breathing, drop in blood pressure and can be life-threatening.

Types of asthma medication

Medication available for the treatment of asthma and other chronic breathing disorders fall into three categories:

bronchodilators treat and relieve symptoms of brochospasm and include beta 2-agonists and anticholinergics.

anti-inflammatory drugs treat the underlying inflammation by inhibiting the production of inflammatory chemicals like prostaglandins and include corticosteroids and non-steroidal anti-inflammatory drugs (NSAID).

Leukotriene receptor antagonists treat both symptoms of brochospasm and inflammation.

Inhaled asthma medication

Most asthma medications are taken using an inhaler so that the drug goes directly to its target, the airways of the lungs. Inhaled asthma medications may be delivered as an aerosol with a metered dose inhaler (puffer) using a propellant gas to create an aerosol, or by a nebuliser that creates a fine mist which can be inhaled using a mask or mouthpiece. The medication may also be inhaled as a dry powder using a special device for powder delivery.

Inhalers are used for brochodilators, or reliever medications that are generally for symptom relief or asthma attack; and for anti-inflammatory drugs, which are preventer medications for chronic inflammation of the airways. Combination inhalers are also available which contain two different drugs in the same inhalation device.

Types of inhaler

Inhaler devices used to deliver medication into the airways are:

Metered dose inhaler (MDI) that uses a propellant gas to create an aerosol. Most are now CFC-free as these less damaging to the environment.

Dry powder inhaler, such as the accuhaler, turbuhaler or rotahaler that does not need a propellant.

Oral asthma/allergy medication

Some steroid medication for severe asthma or allergy can be taken orally as tablets to gain control of symptoms. Leukotriene receptor antagonists are also taken orally as tablets.

Types of allergy medication

Allergy medications are known as antihistamines because they block the action of histamine, a chemical released during an allergic reaction that is responsible for triggering symptoms of allergy. Most antihistamines are taken orally as tablets and are non-sedating. Some antihistamines are sedating because they also act on the central nervous system. Antihistamines can also be taken as eye drops and using a nasal spray.

Nasal sprays for treating allergy

Allergy medications can also be taken as a nasal sprays. The types of medication available as a nasal spray include antihistamines to treat symptoms of allergy; also corticosteroids that treat symptoms of inflammation of the nasal passages caused by an allergic reaction.